You can fool most of the people much of the time, but you can’t fool Mother Nature. And one of the things she’s telling us is that your health is dependent on everyone else’s health. Yes, everybody’s. The real wealth of a people is its health – not its stock market indices.
Viruses are not “foreign” invaders. They don’t have national identities. They’re not even species specific; ask bats and pigs.
Humans have a visceral understanding of pandemics from one of our favorite entertainments – zombie movies. If Brad Pitt gets bitten by a zombie, he can infect his friends, his family, and everyone in future sequels.
Yet pandemics are different from viral pandemics. You see those grimy, bloody zombies coming for you. Viruses are stealthy, microscopic, invisible. Which is one of the reasons why before they kill you they can scare you to death.
Which is what’s been happening in the United States. In good part that comes from national leaders whose concept of health comes from doctor visits and health insurance contracts. That idea is not just wrong, it’s deadly wrong.
Health is about public health, the overall health of a nation’s people, not the cost efficiency of its “health care system.” The World Health Organization definition of health is the complete physical, mental, and social well-being of a population. It’s an aspirational definition, but a very useful one.
By such measures, the United States is a woeful outlier. Our health indices of hard endpoints like life and death are about the same as poor, mismanaged, totalitarian Cuba.
Because public health experts have known for nearly a century that the health of a nation is far more determined by vaccination, sanitation, education and nutrition than by its doctor and hospital system. The vast increase in world lifespan seen in the 20th century came about largely from those factors; even the wonderful invention of antibiotics constitutes a rounding error to the overall death rate of infectious diseases. The same factors are true for personal health. By the Harvard Healthy Habits Study, people who move around a bit, don’t smoke, don’t drink much, keep their weight controlled, live on average 14 years longer for women and 12 years longer for men. What does health care add to personal longevity? There’s plenty of argument, but it’s perhaps 2-3 years, far less as we grow older.
To control the spread of Covid-19 we need something humans can be very good at: cooperation, international, regional, and local. If Taiwan, at first much more at risk than the US, has been able to keep the virus at bay, you copy theirs and others best practices as far as you can.
That means you have public health officials calling the shots, not politicians who think repositioning the flu virus will “defeat” the virus. You don’t have the national health policy meetings “classified” like they are spy sessions, so needed experts can’t attend or know what’s happening. You send out bulletins twice a day across the nation telling people where the problems are, and what behaviors to use to stay well. You organize public and private groups to work together to transparently transmit information quickly and effectively so everybody knows what to do.
You don’t have the epidemic placed under the control of someone who wrote that smoking doesn’t kill people, cut public health funding and watched an AIDS epidemic ravage a county. You don’t promise millions of testing kits when you didn’t order the reagent necessary to make them. You don’t have a CDC director who disregards public Covid-19 testing of the virus because he doesn’t want to “interfere” with the relationship between doctors and their patients. Tell that to the poor and uninsured; what this epidemic should prove is their health affects yours. When historians write the history of this bungled pandemic, the terms epic, great, fantastic and A+++ should garner much ironic use.
Most important, you don’t let a major crisis go to waste. You learn from it. You begin to understand that the Italian who infects you with Covid-19 in Nashville can in turn be infected by you with influenza, and in turn may infect someone from Wuhan. You learn three principles, that 1. The issue is health, not health care. 2. A healthy economy requires a healthy population, which includes the people around the world who make the chemicals necessary for your needed medications 3. A healthy population requires a healthy environment – if you live in a toilet, people get sick. And they’re much more prone to viral infection.
What has saved humanity for hundreds of thousands of years is our herd immunity, our ability to fight off infection as a community. If you knock off highly evolved human immune function, there are enough viruses and bacteria on a single human hand to kill most of us.
To control Covid-19 we need to cooperate, to act as the social animals we are, to recognize that everyone is in this together. We are the same species, and we should act like one. The WHO definition of health as complete physical, mental, and social well-being is not something we are soon to achieve. But it is a real measure of national and human greatness.